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As the NHS navigates through the Five Year Forward View the ongoing financial and service delivery pressures continue to mount. While the NHS has made massive strides in driving efficiency while maintaining the highest quality care the omni-present challenge of improving outcomes with a diminishing pot of money per capita (in real terms, as demand continues to increase) means that cost improvement, quality, innovation, productivity and prevention programmes will endure further interrogation and many will require innovative solutions to ‘change the game’.

A recent Healthcare Survey commissioned by the Kings Fund (March 2017) as part of its QMR details a survey of NHS Trust finance directors (72) and CCG financial leads (39) covering 48 CCG’s were asked about their organisations financial situation and the financial outlook for their local health economy, the financial situation looking ahead to 2017/8 and the key organisational challenges facing Trusts and CCG’s.

Just over half of all Trusts responding to the survey forecast ending 16/17 in deficit. Around 86% of Trust financial directors reported that their forecast position for 16/17 would depend on significant financial support, including 25% who are delaying or cancelling capital spending.

Furthermore, 55% of providers expecting to receive Sustainability and Transformation Fund monies still forecast a deficit by the end of the year.

Equally with 71 per cent of CCGs surveyed reporting their forecast position for 2016/17 depends on significant financial support and half of the CCGs surveyed shared their end-of-year position depends on delay or cancellation of spending; for a further 21 per cent, end-of-year position depends on draw down of surpluses from previous years, and 21 per cent are relying on having their 1 per cent risk reserve released back to them.

So as localised health economies decide on their structures in terms of STP’s moving to ACS and ACO’s dependant on nature and demography, provision never before has the need for innovation been so great.

AposTherapy® is now able to demonstrate NHS based real world outcomes that reinforce the evidence-base that has been generated to date. It has shown significant improvements in pain, function in patients that would have otherwise been referred to an Orthopaedic intervention. This means less referrals into secondary care for joint replacement surgery.

AposTherapy® is not currently widely available as an NHS treatment modality, but the evidence base for providing alternative treatment options for people with intractable knee pain is now proven, with more benefits being shown as the number of recipient’s increases. The model for the NHS as outlined in the 5 Year Forward View (2014) highlights the need to be able to deliver more cost-effective options with better outcomes for the individual, reducing reliance on the NHS in all its forms. The opportunity to deliver a person focused treatment regime, with outcomes that outperform current treatment options and reduces cost should be considered as a way forward for the effective management of resources in a modern health and care system.